重叠式三角吻合在完全腹腔镜右半结肠癌根治术中的应用

Application of overlapping triangular anastomosis in complete laparoscopi c radical operation of right colon cancer

目的:探讨重叠式三角吻合在完全腹腔镜右半结肠癌根治术中应用的安全性及可行性。方法:回顾性分析70例右半结肠癌患者的临床资料,将其分为行重叠式三角吻合的完全腹腔镜右半结肠癌根治手术组(观察组)及腹腔镜辅助右半结肠癌根治手术组(对照组),每组各35例。对比两组的手术时间、肛门恢复排气时间、切口长度、切口疼痛程度、术后并发症发生情况。结果:观察组的手术时间、肛门恢复排气时间分别为(183.23±10.50)min、(63.43±7.12)h,对照组的手术时间、肛门恢复排气时间分别为(184.54±8.73)min、(65.29±7.52)h,两组相比较无显著差异(P>0.05)。观察组的切口长度为(4.47±0.44)cm,短于对照组的切口长度〔(5.66±0.58)cm〕,P<0.05。观察组术后第1、3天的VAS评分为(3.31±0.68)分、(2.34±0.64)分,对照组术后第1、3天的VAS评分为(4.40±0.88)分、(3.03±0.75)分;观察组术后第1、3天的VAS评分均低于对照组,P<0.05。观察组术后出现1例吻合口漏、2例腹腔内感染,对照组术后出现1例吻合口漏、3例腹腔内感染,两组相比较无显著差异(P>0.05)。结论:重叠式三角吻合在完全腹腔镜右半结肠癌根治术中的应用效果较好,能减小切口长度,减轻术后疼痛。

Objective:To investigate the safety and feasibility of overlapping triangle anastomosis in complete laparoscopic radical resection of right colon cancer.Methods:The clinical data of 70 patients with right semicolon carcinoma were retrospectively analyzed,and they were divided into two groups(observation group)and laparoscopic-assisted right semicolon carcinoma radical operation group(control group),35 cases in each group.Operation time,anal exhaust recovery time,incision length,incision pain and postoperative complications were compared between the two groups.Results:The operation time and anal exhaust recovery time were(183.23±10.50)min and(63.43±7.12)h in the observation group,and(184.54±8.73)min and(65.29±7.52)h in the control group,respectively.There was no significant difference between the two groups(P>0.05).The incision length of observation group was(4.47±0.44)cm,which was shorter than that of control group(5.66±0.58)cm,P<0.05.The VAS scores of the observation group were(3.31±0.68)points and(2.34±0.64)points on the 1st and 3rd day after surgery,and the VAS scores of the control group were(4.40±0.88)points and(3.03±0.75)points on the 1st and 3rd day after surgery.The VAS scores of the observation group were lower than those of the control group on the 1st and 3rd day after surgery,P<0.05.There were 1 case of anastomotic leakage and 2 cases of intraperitoneal infection in the observation group after surgery,and 1 case of anastomotic leakage and 3 cases of intraperitoneal infection in the control group after surgery,there was no significant difference between the two groups(P>0.05).Conclusion:The application of overlapping triangle anastomosis in complete laparoscopic radical operation of right colon cancer is better,which can reduce the incision length and relieve postoperative pain.